Individual
MR. KEITH EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
288 FLYNN AVE APT 26, BURLINGTON, VT 05401-5370
(802) 238-0058
Mailing address
288 FLYNN AVE APT 26, BURLINGTON, VT 05401-5370
(802) 238-0058
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000767
VT
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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